NHS Complaints Advocacy
If you feel unhappy about a NHS service you have received, we are here to help. Our NHS Complaints Advocacy Service will ensure you know all your options, your rights and how to make sure your voice is heard.
Our service is free, independent and confidential and available to all Reading residents. Last year (2017-18), we helped 82 people make formal NHS complaints, and assisted a further 160 with advice about sorting out problems before they escalated.
Our NHS Complaints Advocacy Service is part of the Reading Voice Advocacy Hub based in the town centre. Our service offers three levels of support:
- Simple Self-Help: Use our online or paper guides to support yourself through the complaints process
- Supported Self-Help: A one-off meeting with an advocate and/or telephone support to guide you through the complaints process
- Full Advocacy Support: For people with extra communication or other needs, this could include drafting your complaint letters and/or attending resolution meetings with you
“As a direct result of the meeting with the NHS managers that Healthwatch Reading arranged, they realised that my medical condition was much more complex than first thought, so they have now put me on a special priority list if I call 999 again. The best thing about the advocate was how supportive and knowledgable they were.”
Client feedback from Reading man, aged 69
You can find answers to common questions below.
Everybody has the right to make a complaint about the NHS. This is set out in the NHS Constitution.
You can make a complaint in writing or verbally, and the NHS organisation you complain to must acknowledge receipt of your complaint within three days, properly investigate your concerns and tell you how long the investigation will take. Usually organisations will respond in a month, but sometimes they will ask for longer if your case is complex. If you are unhappy with the response, you can request a 'local resolution meeting' with senior managers at the organisation to discuss your concerns.
If you are still dissatisfied with the NHS organisation’s response and the way the NHS organisation handled your complaint, you can ask the Parliamentary and Health Services Ombudsman (PHSO) to look at your complaint. If the PHSO decide to look into your case, they will talk to both you and the NHS organisation, and also consult their own expert doctors, before deciding if they will uphold your complaint.
Any Reading resident can use our service, even if the NHS care was provided outside of Reading. A Reading resident is a person who pays their council tax to Reading Borough Council. You can find out if you are a Reading resident, by putting your postcode into this checker.
If you live immediately outside of Reading (such as in Wokingham, West Berkshire, or Oxfordshire), but are making a complaint about NHS care received in Reading, you will need to use a different advocacy organisation, called Seap, on telephone 0330 440 9000.
If you live in another area and are not sure where to get help, you can call your local Healthwatch to find out which organisation can assist with NHS complaints. You can find your local Healthwatch using a search tool on the home page of Healthwatch England’s website.
A family member, carer, friend, or your local MP, can complain on your behalf with your permission, or in certain situations where the person lacks capacity to make a complaint.
Organisations usually require proof that the person has given their permission for another person to handle their complaint, such as a signed consent form.
If you are a parent, you can make a complaint about the NHS care of a child aged under 16, but organisations may still seek permission from the child for you to do this, if they think the child is capable of this.
You can also make a complaint about the care of a person who has died.
Complaints can involve looking at people’s medical records, which are confidential. Relatives, spouses, or partners do not have automatic rights to know what are in the medical records of loved ones and the NHS organisation will have procedures on when and how it will share this information to others.
Healthwatch Reading advocates will also usually seek to talk to the individual directly affected by the NHS concern, to check their wishes, and obtain their consent for another person to handle their complaint.
Your concern will be unique to your own circumstances, but people usually come to us for help resolving issues about:
- Care or treatment
- Staff attitude
- Waiting times
- Poor communication
- Problems with hospital discharge
- Denial of access to treatment, medications or equipment
- Charges for some treatment or items
- NHS access for overseas visitors
- NHS access for refugees, asylum seekers or trafficked people
- Missed or wrong diagnosis
- Care before death
You can make a complaint about any NHS funded service. This includes:
- GP surgeries
- Hospitals (including A&E, outpatient clinics, or inpatient stays)
- Ambulance services, including emergency response and non-urgent patient transport
- Any private treatment funded by the NHS
- Mental health services
- Maternity services
- NHS 111 helpline
- NHS walk-in centre or minor injury unit
- Community care such as district nursing or health visitor services
- Community pharmacies
- Community opticians
- Twelve months of the incident happening or
- Within twelve months of you realising that you have something to complain about
The NHS can use its discretion to look at issues that are beyond these timescales. For example, if you were too ill to make the complaint straight away the NHS will consider if it is still possible to investigate the complaint effectively and fairly.
Our advocates offer three levels of support:
Level 1: Simple self-help advice – whether that’s giving you the telephone number of a particular local NHS PALS or complaint department, an overview of your complaints rights, and/or advice on how to manage your own complaint, including signposting to all our online guides. This will suit literate people who are able to manage their own correspondence and speak for themselves.
Level 2: Supported self-help.This includes all the help offered at Level 1, plus some extra input for people who would might need more time or assistance to empower them to handle the complaint themselves. This might involve a one-off, 60-minute meeting with an advocate at our central Reading office to get detailed advice; telephone feedback from an advocate on the wording of your draft complaint letter; or a quick call to check your options once an organisation has responded to your complaint.
Level 3: Full advocacy support.This service is for people who need an advocate to manage the complaint on their behalf because they have extra needs or are vulnerable due to factors such as ongoing illness, being recently bereaved, having a disability, or being unable to fully understand or communicate. Some people who feel very let down or whose concerns are very serious, may also feel emotionally unable to directly communicate with the NHS service. If an advocate manages your complaint, their support could include:
- Meeting you at your home or place of care
- Adapting to your communication needs, such as Easy-Read, a translator, or an interpreter
- Writing and submitting complaints on your behalf
- Ensuring the NHS organisation responds by the deadline
- Ensuring the NHS organisation responds in a way you can understand
- Putting across your views at a local resolution meeting
- Regular updates on the progress of your complaint and your options at every stage
- Taking your case to the Parliamentary and Health Service Ombudsman if you choose
Our NHS Complaints Advocates have gained, or are studying towards, the Level 2 City and Guilds Award in Independent Advocacy.
All our advocates must also:
- be DBS-checked
- have undergone Level 1 safeguarding training
- follow the nationally recognised Code of Practice for Advocates
- follow Healthwatch Reading policies, including those on equality and diversity, data protection and lone working.
Most people who seek our help tell us they are motivated to make a complaint because they don’t want the same thing happening to future patients.
The NHS complaints process can help you get:
- an explanation on why something went wrong
- an explanation about why you are receiving a particular course of care or treatment
- a further appointment or review of your care if the NHS agrees this is needed
- an explanation about what the NHS organisation will do to make any necessary improvements
- an apology
- a meeting with senior staff from the organisation to discuss your case in more detail.
You cannot request that a particular member of NHS staff be disciplined, but patient complaints may prompt NHS organisations to launch their own disciplinary procedures.
If you believe a particular doctor, nurse or other NHS staff member has made a serious mistake that has caused harm or behaved inappropriately, you have the option of reporting them to their professional regulatory body. These organisations decide if health or care professionals need to be investigated, re-trained, or in the most serious cases, banned from working. You can find out names and contact details for all regulators in this leaflet.
NHS Complaints Advocacy does not cover helping people to claim compensation, or to ‘sue the NHS’.
We refer people who are seeking compensation, to a national patient safety and justice charity called AVMA (Action Against Medical Accidents). Visit their website at www.avma.org.ukor telephone their helpline on 0845 123 2352.
AVMA encourages people to first pursue their concerns through the NHS Complaints Process before taking any legal action.
The public has 35 legal NHS rights, covering everything from free care, waiting times, access to medical records, patient confidentiality, making a complaint, and many more.
Your rights (as well as nine main patient ‘responsibilities’ such as keeping your appointments), are set out in the NHS Constitution. Detailed information on maximum waiting times, are contained in The Handbook to the NHS Constitution.
You have six key rights covering complaints:
You have the right:
- To have any complaint you make about NHS services acknowledged within three working days and to have it properly investigated;
- To discuss the manner in which the complaint is to be handled, and to know the period within which the investigation is likely to be completed and the response sent;
- To be kept informed of progress and to know the outcome of any investigation into your complaint, including an explanation of the conclusions and confirmation that any action needed in consequence of the complaint has been taken or is proposed to be taken;
- To take your complaint to the independent Parliamentary and Health Service Ombudsmanor Local Government Ombudsman, if you are not satisfied with the way your complaint has been dealt with by the NHS;
- To make a claim for judicial review if you think you have been directly affected by an unlawful act or decision of an NHS body or local authority;
- To compensation where you have been harmed by negligent treatment.
The constitution also says that the NHS commits to:
- ensure that you are treated with courtesy and you receive appropriate support throughout the handling of a complaint; and that the fact that you have complained will not adversely affect your future treatment;
- ensure that when mistakes happen or if you are harmed while receiving health care you receive an appropriate explanation and apology, delivered with sensitivity and recognition of the trauma you have experienced, and know that lessons will be learned to help avoid a similar incident occurring again;
- ensure that the organisation learns lessons from complaints and claims and uses these to improve NHS services.
People have a right to see information held about them, under the Data Protection Act (1998) and Access to Health Records Act (1990). You do this by making what is called a ‘Subject Access Request’.
You can request to view your medical records for free in the presence of a designated NHS employee at the place where they are held, or you can request copies of your records to take away for a cost of up to £50.
NHS organisations mustmake records available within 40 days of your request (and any payment being made), and ideally within 21 days. Organisations can deny you access if they feel that disclosure would be ‘likely to cause serious harm to the physical of mental health or condition’ of you or another person.
Health records are normally kept for only eight years after a person has died. There are rules about who can see the records of a deceased person and you could have to provide proof, such as being an executor of the deceased person’s estate.
If you think something in your records is wrong you can ask for an explanation, addition or note to be made on your records.
Some NHS organisations will agree to an informal verbal request to see your records, but most usually ask you to complete a Subject Access Request form. You have to approach the NHS organisation that holds the information you are interested in – whether your GP, hospital, dentist, optician, or other type of healthcare provider.
Here are some quick links to medical records departments of Reading NHS organisations:
For GP or dental records, ask the manager of the surgery or practice, how to make the request.
If you need assistance in completing forms because of illness, disability, or language issues, or you want advice about a denied request, please contact our Advocacy Hub.
You can check whether your NHS treatment or medication follows national or local guidelines, to help you decide if you have any grounds for a complaint. These guidelines are drawn up after experts have checked all the available clinical evidence about how good treatments are. Some guidelines will also be based on funding decisions.
The main national guidance is published by the National Institute for Health and Care Excellence. NICE gives very detailed guidance to the NHS and doctors about how certain conditions and disease should be diagnosed, treated, or managed.
People can also get guidance on What to expect from a good care service, from the Care Quality Commission, the national body that inspects NHS services and which can take action such as ordering improvements or closing down failing services.
The organisation that funds and plans NHS services for people in Reading (Berkshire West Clinical Commissioning Groups) also produces local information on what NHS services they will not normally fundand how people can apply for an individual decision about their treatment.
Find out the costs of NHS prescriptions, dental work, eye tests, wigs, and patient transport on the Help with Health Costs sectionof the NHS Choices website.
Charges and exemptions are decided on a range of factors such as your age, income or benefits, clinical condition, or circumstances.
Our service can give you information about the Continuing Healthcare (CHC) process, and help to appeal any decisions by the local NHS which reject a CHC application.
CHC is a package of health care outside of hospital, and sometimes personal care, funded solely by the NHS, for people who have serious, ongoing conditions or needs. It can pay for things like specialist nurses or therapies in your own homes, or care home costs.
If you need free, expert advice about CHC applications quickly, you can contact a national social enterprise called Beacon that gives the public a free 90 minute phone consultation with CHC caseworkers, call 0345 548 0300.
Here are some common questions and answers about CHC:
Who is eligible for CHC?
Anyone over 18 who has a certain level of care needs. You do not get it automatically if you have a particular disease, diagnosis or condition. Instead, health and/or social professionals assess you, looking at:
- what help is needed
- how complex these needs are
- how intense or severe these needs can be
- how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time
How do I apply for CHC?
The first stage involves a health professional or social worker completing an initial national check list to see if you would be eligible to apply for full funding. If you are eligible, you move on to the second stage, which involves a full assessment being carried out by a multidisciplinary team, looking at your needs in more detail to decide whether to recommend full funding.
This team will use a national document called a Decision Support Tool. You should be present at the decision-making meeting – or be able to pass on your views through prior conversations, or by having a representative such as a relative or advocate at the meeting.
The final decision is made by your local clinical commissioning group, ideally within 28 days of the referral to full assessment. This can be fast-tracked in urgent cases, such as when somebody is terminally ill.
Decisions on CHC applications by Reading people, are made by Berkshire West Clinical Commissioning Groups. They have a special team to advise the public on how to request an assessment, and how the local process works.
What can I do if my application for CHC is rejected?
If the initial check list results in your application being unsuccessful, you can ask the clinical commissioning group (CCG) to reconsider the decision. I
If your application is unsuccessful after going through the full Decision Support Tool process, you can ask the CCG to carry out a local review of the decision, or to send it to an NHS England independent review panel.
You can get information, advice or help with appeals from the national social enterprise Beacon. It claims a 70% success rate in appeals, and can offer people a free 90-minute phone consultation. Beacon grew out of a service initially run by Age UK Oxfordshire.
If these actions do not change the original decision, and you are still unhappy, you can make a complaint to the Parliamentary and Health Service Ombudsman (PHSO). Healthwatch Reading can help people, once they have exhausted the appeals procedures, by advising or assisting them to put forward complaints to the Parliamentary and Health Service Ombudsman (PHSO).
Quick Guides and Template Complaint Letters for...
Step 1: Try to resolve firstly by asking to speak to the practice manager.
Step 2: If you decide to make a formal complaint, you can use our Template Letter of Complaint to GP Surgery.
If you do not want to deal with the GP surgery directly, then lodge your complaint via NHS England by calling 0300 311 2233 or emailing: England.email@example.com.
Step 1: Try to resolve firstly by asking to speak to the manager of the dental surgery.
Step 2: If you decide to make a formal complaint, you can use our Template Letter of Complaint to Dental Surgery.
If you do not want to deal with the dental surgery directly, then lodge your complaint via NHS England by calling 0300 311 2233 or emailing: England.firstname.lastname@example.org.
Step 1: Try to resolve firstly by contacting the Royal Berkshire Hospital’s Patient Relations department on 0118 322 8338 or email email: email@example.com
Step 2: If you decide to make a formal complaint, you can use our Template Letter of Complaint to Royal Berkshire Hospital. If you send by email, send to Complaints@royalberkshire.nhs.uk.
Step 1: Try to resolve firstly by contacting the PALS department at Berkshire Healthcare NHS Foundation Trust, which runs mental health and community services, on 0118 9605027 or email BHT@berkshire.nhs.uk.
Step 2: If you decide to make a formal complaint you can use our Template Letter of Complaint to Berkshire Healthcare NHS Foundation Trust, and contact BHFT’s Complaints department at 01344 415662 or email BHCT.firstname.lastname@example.org.
Sometimes the NHS pays private organisations to carry out work such as routine operations, with shorter waiting times. If something goes wrong, you can ask the organisation to investigate, or you may wish to direct your complaint through Berkshire West Clinical Commissioning Groups, which pays for this treatment.
Step 1: Firstly, contact the organisation’s patient complaints or customer services department to try and resolve the issue.
Step 2: If you decide to make a complaint, you can use our Template Letter to Private Provider of NHS Service.
Berkshire West Clinical Commissioning Groups (BWCCGs) is responsible for planning and funding most NHS services – including GPs, hospitals and mental health services - for Reading people. You may wish to approach them if you don’t want to directly deal with the NHS organisation yourself, if you feel the CCGs need to be made aware of serious concerns, or if you feel you have been wrongly denied certain care, treatment or medication.
Step 1: Firstly, contact the CCGs’ PALS service for initial question or concerns, by phoning 0300 123 6528 or email email@example.com.
Step 2: If you want the CCGs to investigate your complaint, you can use our Template Letter of Complaint to CCGs.
Speak up as soon as you can
Raising your concern as early as possible can often nip the problem in the bud and avoid the need for lengthy, formal complaints procedures. Ask a senior staff member – such as the practice manager at your GP surgery, or a ward sister in hospital – to listen to your concerns. You might have highlighted something that senior staff did not know about, or raised an issue they can simply and quickly sort out for you.
Larger NHS organisations such as hospitals will have a dedicated Patient Advice and Liaison Service (PALS) on site to help people with immediate queries or concerns. If speaking to a senior person didn’t help or they weren’t available, then try calling PALS. They will know the organisation’s staff, working practices, and policies and also should know about patient rights.
Decide what outcome you want
Your NHS experience may have caused you to feel let down, angry, hopeless, unwell or bereaved, but unsure how it can be fixed. Talk to a friend, relative or one of our advocates, to help decide what matters most to you – do you want an apology, an explanation of what went wrong, further care, or an assurance that the organisation has learned from the mistake? Being clear can help your complaint be answered more thoroughly and quickly.
Use our template complaint letters
Our template letters will prompt you to include all the relevant and necessary information to ensure your complaint is not held up. We have included the names and addresses of some larger NHS organisations in Reading, on some of the templates.
If you want to write your own letters, we advise that you:
- Include your full name, date of birth, NHS number, address and a daytime contact number
- Inform the organisation of any special communication needs
- Summarise your complaint in one sentence near the start of your letter
- Explain the personal impact the issue had on you
- Include any relevant dates (or a separate timeline of events for complex cases)
- Include the names of any staff, wards, clinics or other information that the organisation can use to investigate your complaint
- Avoid any aggressive or abusive language
- State clearly what outcome you are seeking.
Keep copies of all your complaint letters and/or emails with the NHS organisation, and notes from any phone calls you may have with their complaints department.
Know that making complaints makes a difference
People often wonder whether speaking up about their NHS concerns is worth it. For the families of 10 people across England who died from blood poisoning, speaking up has made a difference. The Parliamentary and Health Service Ombudsman (PHSO) – the final stage for people still unhappy with their NHS complaint outcome – published a report about the 10 deaths in 2013, saying that these people could have been saved if their symptoms of sepsis were identified and treated earlier. As a result, doctors and other healthcare professionals now have to follow new national guidance about recognising sepsis, the government has funded a public awareness campaign for parents on signs and symptoms, and local areas are now rated on their sepsis actions.
Where Healthwatch Reading spots trends of rising complaints from people about the same organisation or issue, we will also escalate our concerns. We blew the whistle about poor care at two GP surgeries soon after they were taken over by the same organisation, and this resulted in the surgeries being officially investigated and ordered to make improvements.
We have also helped many individuals with their unique cases - whether getting answers about the unexpected death of a child, the delayed diagnosis of a serious illness, or challenging the way NHS staff speak to people or cater for extra needs such as disabilities.
An elderly woman rang our Advocacy Hub to say she was still waiting for a repeat prescription from her GP surgery that she had submitted six days’ beforehand. Repeat prescriptions were normally supposed to be turned around within 48 hours. The woman said she had had the same problem the month before and despite writing to the practice, the problem was happening again. The prescription included vital blood pressure medication. With the woman’s permission, one of our advocates spoke to senior staff at the organisation and the repeat prescription was arranged straight away.